Publications by authors named "Catherine McCarey"

5 Publications

  • Page 1 of 1

Fertistat: a potential tool for adolescent sexual health.

J Pediatr Adolesc Gynecol 2021 May 11. Epub 2021 May 11.

Geneva University Hospitals, Department of Woman, Child and Adolescent, Catherine McCarey, Department of Woman, Child and Adolescent, Geneva University Hospitals, 30, boulevard de la Cluse, 1205 Geneva, Switzerland.

The FertiStat (fertility status awareness) tool provides personalized advice on reducing risk factors for infertility and seeking medical advice based on lifestyle and reproductive profile.

Study Objective: The aim of our research was to test the FertiStat tool in younger patients (14-24 years). A secondary objective was to screen for and evaluate knowledge of risk factors impacting fertility.

Methods: Patients aged 14-24 years attending consultations at Geneva University Hospitals received a quantitative questionnaire before consultations. Questions covered lifestyle, gynecological history, perception of fertility and pregnancy intent. We investigated respondents' beliefs with regard to risk factors for infertility through "true/false" questions. We selected questions relevant to our population from the original FertiStat questionnaire to calculate each respondent's FertiStat score. Scores range from "blue" (low-risk) to "red" (risk of infertility).

Results: A total of 279 women aged 14-24 were included. Non-pregnant patients had overall higher FertiStat scores (2.7±0.8). Upon logistic regression analysis, with every additional FertiStat point, the odds of being pregnant at the time of survey decreased by 0.48. Risk factors for infertility and knowledge of these risk factors were equally distributed between pregnant and non-pregnant women.

Conclusion: Our findings suggest FertiStat may be a useful tool in the younger population we extended it to and highlight gaps in knowledge on risk factors for infertility. These findings are of interest when considering FertiStat as a starting point to discuss contraception and risk factors for infertility at an age at which risk mitigation would prove most effective in preserving future fertility.
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May 2021

[Clinical value of angiogenic and anti-angiogenic marker assay in preeclampsia].

Rev Med Suisse 2020 Oct;16(712):2031-2036

Service d'obstétrique, Département femme-mère-enfant, CHUV, 1011 Lausanne.

Preeclampsia is a disease which originates in the placenta and is specific to human pregnancy. It is one of the main causes of maternal and perinatal morbidity and mortality. The introduction of assays for angiogenic and anti-angiogenic markers reflecting placental dysfunction, which lies at the root of preeclampsia, is a turning point in the management of women with suspected preeclampsia or with an atypical form of the disease. The sFlt1/PlGF ratio assay, which has been covered by health insurance since July 2019, is a valuable diagnostic aid : the disease can be ruled out, with a high negative predictive value, when the ratio is low, thus avoiding unnecessary hospital admission and premature delivery. A high ratio can help to confirm the diagnosis of preeclampsia, albeit with a lower positive predictive value.
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October 2020

Preparing an obstetric unit in the heart of the epidemic strike of COVID-19: quick reorganization tips.

J Matern Fetal Neonatal Med 2020 Apr 12:1-7. Epub 2020 Apr 12.

Department of Obstetrics and Gynecology, Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.

COVID-19 is placing considerable strain on healthcare systems. Disaster and military medicine specialists were involved in the outbreak in Italy, after many units were overwhelmed. Health providers were caught off guard and personnel was unprepared to face this unprecedented threat. Local decisions accelerated the rate of the spread. Many countries declared a state of emergency and lockdown to contain the exponential transmission of the disease. The purpose of this review is to suggest quick key points of strategies to implement in obstetric units without delay to respond to the oncoming wave, based on experience and feedback from the field. It is essential in an emergency situation to understand what is at stake and prepare maternity wards in the best possible way.
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April 2020

HPV self-sampling as primary screening test in sub-Saharan Africa: implication for a triaging strategy.

Int J Cancer 2014 Oct 4;135(8):1911-7. Epub 2014 Apr 4.

Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.

Our objective was (i) to assess if a self-collected test for human papillomavirus (HPV) may serve as a primary cervical cancer screening method in a low-resource setting, (ii) to evaluate its implication in a screen and treat approach and (iii) to identify the most eligible age group in a screening program. Women were recruited through a cervical cancer screening campaign conducted in Cameroon. Written and oral instructions were given to participants by a health-care professional to carry out an unsupervised self-collected HPV-test (Self-HPV), followed by a physician-collected cervical sample for HPV testing (Physician-HPV) and cytology. Differences in performance between Self-HPV versus Physician-HPV and their ability to detect abnormal cytology results (ASC-US+) were evaluated. Descriptive analyses were used to examine the correlation between HPV positivity and cervical abnormalities by age. A sample of 789 women was prospectively enrolled. HPV prevalence was 14.6% and 12.7% for Self-HPV and Physician-HPV, respectively (Cohen's kappa = 0.74). HPV positivity by cytological diagnosis for ASC-US+ was similar with the two tests. positive predictive value of the Self-HPV for ASC-US+ was 20.4; odds ratio and number needed to treat were 6.5 (3.2-13.4) and 6 (4.2-10.9), respectively. We observed a trend of increasing cytological abnormalities in 30-49 year-old women and a concomitant trend of decreasing HPV prevalence supporting that this age group might be the most eligible group for screening. In conclusion, Self-HPV can be used as a primary screening test but needs to be followed by a triaging test that would identify the subset of women affected by clinically significant precancer or cancer.
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October 2014

Awareness of HPV and cervical cancer prevention among Cameroonian healthcare workers.

BMC Womens Health 2011 Oct 18;11:45. Epub 2011 Oct 18.

Geneva University School of Medicine, Genève, Switzerland.

Background: Cervical cancer, although largely preventable, remains the most common cause of cancer mortality among women in low-resource countries.The objective of this study was to assess knowledge and awareness of cervical cancer prevention among Cameroonian healthcare workers.

Methods: A cross-sectional self-administered questionnaire in 5 parts with 46 items regarding cervical cancer etiology and prevention was addressed to healthcare workers in six hospitals of Yaoundé, Cameroon. The investigators enlisted heads of nursing and midwifery to distribute questionnaires to their staff, recruited doctors individually, in hospitals and during conferences and distributed questionnaires to students in Yaoundé University Hospital and Medical School. Eight hundred and fifty questionnaires were distributed, 401 collected. Data were analyzed with SPSS version 16.0. Chi-square tests were used and P-values < 0.05 were considered significant.

Results: Mean age of respondents was 38 years (range 20-71 years). Most participants were aware that cervical cancer is a major public health concern (86%), were able to identify the most important etiological factors (58%) and believed that screening may prevent cervical cancer (90%) and may be performed by Pap test (84%). However, less than half considered VIA or HPV tests screening tests (38 and 47%, respectively). Knowledge about cancer etiology and screening was lowest among nurse/midwives.

Conclusion: Knowledge of cervical cancer and prevention by screening showed several gaps and important misconceptions regarding screening methods.Creating awareness among healthcare workers on risk factors and current methods for cervical cancer screening is a necessary step towards implementing effective prevention programs.
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October 2011